Objective: To investigate the biological behavior and prognosis factors of type B3 thymoma, and evaluate the efficacy of radiotherapy in patients with type B3 thymoma. Methods: A total of 188 consecutive patients with pathologically confirmed type B3 thymoma were treated in Shanghai Chest Hospital from January 2001 to December 2010. According to Masaoka stageing criteria, 35 (20%) were stage, 20 (11%) were stage, 78 (44%) were stage, and 44 (25%) were stage. Myasthenia gravis coexisted in 54 patients. Results: After a median follow-up of 49 months (7-135 months), the 5-year overall survival rate was 84% (100.0%, 89.0%, 86.1% and 59.8% of stages and respectively), and the 5-year progression-free survival rate was 65% (100.0%, 94.0%, 67.3%, and 33.0% of stages, and respectively).The reccurence rate was 22% and the metastatic rate was 7%. In the univariate analysis, tumor size, Masaoka stage, resection margin, radiotherapy and chemotherapy were significantly associated with 5-year overall survival and progression-free survival (P < 0.05). In the multivariate analysis, Masaoka stage, resection margin and radiotherapy were independent prognostic factors of 5-year progression-free survival (P < 0.05). Radiotherapy could improve the regional control rate and the overall survival of Masaoka stages ?-? patients. The intensity-modulated radiation therapy of pleure could probably improve the overall survival of recurrent patients. Conclusion: The major failure mode for type B3 thymoma is the recurrence of pleure. Radiotherapy can improve the regional control rate and the overall survival of the advanced patients. The intensity-modulated radiation therapy may be the best therapy for the postoperative recurrence of pleure. Copyright © 2013 by TUMOR.

Objective To provide updated recommendations for further adjustment of iodine deficiency disorders control strategy by evaluating awareness of the dangers of iodine deficiency disorders and their prevention and control measures among local residents and the willingness of choosing iodized or non-iodized salt in urban communities of Jiangsu province.Methods Trained health service workers did questionnaire investigation on iodine deficiency disorders prevention knowledge by calling computer-randomly selected family telephone numbers in every two blocks of provincial capital (Nanjing) and coastal city (Nantong) in Jiangsu province in 2010.The survey topics covered include:when supplied with both non-iodized and iodized salt,what kind of salt the local residents chose and the reasons; residents awareness of the dangers of iodine deficiency disorders and their prevention and control measures; resident's personal information(including only occupational category and age group).Key fields were rechecked from 10％ randomly selected valid questionnaires.Results Four hundred and fifty-five valid questionnaires were obtained by calling 2021 randomized telephone numbers in Nanjing and Nantong cities.After 10.1％(46/455) of the valid questionnaires were rechecked,the total coincidence rate was 87.0％(40/46).In the two cities,there were 73.2％ (333/455) of those 455 respondents saying they would choose iodized salt when iodized and non-iodized salt were supplied at the same time.There were 69.0％(314/455) of respondents had heard of iodine deficiency disorders,of which 79.6％(250/314) of them were aware of the dangers of iodine deficiency is endemic goiter,and 10.8％ (34/314) of them knew that iodine deficiency can cause varying degrees of mental damage.With respect to useful preventive methods of iodine deficiency disorders,there were 69.4％ (218/314) respondents know that eating iodized salt,and 41.1％ (129/314) respondents know that taking laver or kelp would prevent iodine deficiency disorders.Conclusions Remarkable achievements on iodine deficiency disorders health promotion and health education have been gained in urban communities of both the provincial capital and the coastal city Jiangsu province.However,some of the people are still not very clear why we should eat iodized salt.Salt industry in the current management system,is still premature to provide iodized salt and non-iodized salt simultaneously now.

BACKGROUND: Ulinastatin (UTI) is a urinary trypsin inhibitor extracted and purified from urine of males. This study aimed to explore the effects of UTI on paraquat-induced-oxidative stress in human type II alveolar epithelial cells. METHODS: The human type II alveolar epithelial cel s, A549 cel s, were cultured in vitro. The A549 cel s were treated with different concentrations of paraquat (200, 400, 600, 800, 1000, 1200 μmol/L) and ulinastatin(0, 2000, 4000, 6000, 8000 U/mL) for 24 hours, the cell viability was measured by cell counting kit-8 and the median lethal concentration was selected. In order to establish an in vitro model of paraquat intoxication and to determine the safe dose of ulinastatin, we calculated LD50 using cell counting kit-8 to determine the survival rate of the cells. A549 cells were divided into normal control group, paraquat group and paraquat+ulinastatin group. The levels of malondialdehyde (MDA) and myeloperoxidase (MPO) were detected by biochemistry colorimetry, while the level of reactive oxygen spies (ROS) was detected by DCFH-DA assay. RESULTS: The survival rate of A549 cells treated with different concentrations of paraquat decreased in a concentration-dependent manner. Whereas there was no decrease in the survival rate of cells treated with 0–4000 U/mL ulinastatin. The levels of MDA, MPO, and ROS were significantly higher in the paraquat group than in the normal control group after 24-hour-exposure. And the survival rate of the paraquat+ulinastatin group was higher than that of the paraquat group, but lower than that of the normal control group. The levels of MDA, MPO, and ROS were lower than those of the paraquat group. CONCLUSION: Ulinastatin can alleviate the paraquat-induced A549 cell damage by reducing oxidative stress.

Objective To investigate prevalence of metabolic syndrome (MS) in population at high-risk for diabetes in Changfeng community of Shanghai. Methods Totally, 982 persons aged 40-79 years without previous history of diabetes, but with risk factors for diabetes from Changfeng community in Shanghai were screened by questionnaire, physical examinations, lipid profile and oral glucose tolerance test. Prevalence of MS and its clinical characteristic were observed. Results Overall prevalence of MS was 44. 6% (438/982) in Changfeng community, significantly higher in women of 48.6% (341/701) than that in men of 34. 5% (97/281) (P<0.01). Prevalence of MS increased with age in women (P <0. 01 ), but not in men (P>0.05). Components of MS ranking from high to low were hypertension of 66. 5% (653/982), abdominal obesity of 62.8% (617/982), decreased high-density lipoprotein-cholesterol (HDL-C) of 49. 4% (485/982), increased triglyceride (TG) of 46. 0% (452/982) and increased fasting glucose of 35.7% (351/982). There were 55.9% (245/438) of MS patients with three or more MS components in addition to abdominal obesity. Conclusions Prevalence of MS is higher in community population at high-risk for diabetes and more than half of the MS patients have three or more risk factors for cardiovascular disease.

Objective:To study the effect of insulin intraperitoneal administration combined with dietary intervention on glycemic regulation in in KKAy mice with spontaneous type 2 diabetes.Methods:An animal model of type 2 diabetes was established, and healthy C57BL/6J mice were selected as the normal control group and healthy KKAy mice as the non-disease group. The successfully modeled KKAy mice were randomly divided into the subcutaneous group, the intraperitoneal group, and the untreated group. The non-disease group was given a maintenance diet, and all other groups were fed a high-fat, high-sugar diet. The daily feeding time was from 08:00 to 20:00, with one feeding at a 4-hour interval, for a total of four times. The subcutaneous and intraperitoneal groups were given subcutaneous and intraperitoneal insulin injections before feeding, and recombinant glargine insulin injection (subcutaneous group: 0.125 IU/g; intraperitoneal group: 0.250 IU/g) was injected before the first feeding, and biosynthetic human insulin injection (subcutaneous group: 0.075 IU/g; intraperitoneal group: 0.125 IU/g) was injected after a 0.5 h interval; the rest 3 times before feeding, the biosynthetic human insulin injection (subcutaneous group: 0.075 IU/g; intraperitoneal group: 0.125 IU/g) was injected for 4 weeks. The dietary intake, body mass, fasting blood glucose, and 1 and 2 h postprandial blood glucose of mice in each group were tested regularly, and an oral glucose tolerance test was performed.Results:The total dietary intake of mice in the intraperitoneal group was lower than that in the subcutaneous group. Compared with the initial body mass, the body mass of the mice in the subcutaneous and intraperitoneal groups decreased by 5.05 and 3.59 g at week 4, respectively. The changes of fasting blood glucose in the subcutaneous and intraperitoneal groups ranged from 5.4 to 9.4 and 5.4 to 6.4 mmol/L, respectively, and the changes of 1 h postprandial blood glucose ranged from 4.6 to 12.3 and 5.7 to 8.9 mmol/L, respectively, and the changes of 2 h postprandial blood glucose ranged from 2.5 to 9.8 and 3.8 to 7.1 mmol/L, respectively. For the glucose tolerance index, the intraperitoneal group showed improvement at all time points, and the subcutaneous group showed a decrease at all time points except for 0 and 60 min.Conclusions:In combination with dietary intervention, insulin intraperitoneal injection was more effective in controlling blood glucose in KKAy mice with spontaneous type 2 diabetes compared with subcutaneous insulin injection, and had a significant improvement in glucose tolerance.

Objective:To explore the role expectations of stroke advanced practice nurses from multiple perspectives based on the framework of role theory, so as to provide clinical insights for the development of advanced practice nurse roles and the cultivation of core competencies in China.Methods:A phenomenological approach in qualitative research was used. The staffs and trainees, patients and family members in an advanced stroke center in Xuanwu Hospital Capital Medical University in January to February 2023 were selected by purposive sampling method. Participants included stroke specialist nurses, stroke ward physicians and nurses, stroke green channel physicians, stroke ward managers, patients, and family members, totaling seven categories. Semi-structured interviews were conducted, and the content was analyzed using Colaizzi ′s seven-step analysis method. Results:Finally, 28 interviewees were included. There were 9 males and 19 females, aged 29-67 years old. The role expectations for stroke advanced practice nurses were mainly focused on 4 categories:quality expectations (having leadership and execution skills), image expectations(education organizers, innovation promoters, supervisory feedback providers, and other image), obligation expectations (prescription issuance and establishment of outpatient clinics), behavior expectations (evaluation and decision-making, execution and coordination).Conclusions:Stroke advanced practice nurses were assigned multiple role expectations in actual clinical practice, and the promotion of stroke advanced practice nurses is of great relevance in promoting the quality of health care and expanding the scope of nursing practice.

OBJECTIVETo investigate the effect of docosahexaenoic acid (DHA) on invasiveness of aflatoxin B1 (AFB1)-induced hepatocellular carcinoma cells in vitro.

METHODSHepG2.2.15 cells were exposed to different concentrations of AFB1 and DHA plus AFB1. The cell migration and invasion were assessed using wound-healing and Transwell assay, and flow cytometry was used to analyze the cell cycle changes. The ultrastructural changes of the cells were observed by transmission electron microscopy.

RESULTSCompared with the control group, the cells exposed to2 µmol/L AFB1 showed obviously enhanced migration and invasion with decreased cell ratio in G1/G1 phase and increased cell ratio in G2/M phase but no changes in S phase cells; transmission electron microscopy revealed the presence of multiple nucleoli and significantly increased mitochondria and Golgi apparatus in the exposed cells. Compared with AFB1-exposed cells, the cells treated with DHA and AFB1 showed decreased migration and invasion abilities, and the G1/G1 phase cells increased and G2/M phase cells decreased significantly; ultrastructurally, the cells contained single nucleoli with decreased mitochondria and vacuolization occurred in the cytoplasm.

CONCLUSIONDHA can significantly inhibit AFB1-induced enhancement of cell migration and invasion in hepatocellular carcinoma cells in vitro.

Aflatoxin B1 ; pharmacology ; Carcinoma, Hepatocellular ; pathology ; Cell Cycle ; Cell Movement ; drug effects ; Docosahexaenoic Acids ; pharmacology ; Golgi Apparatus ; Hep G2 Cells ; Humans ; Liver Neoplasms ; pathology ; Mitochondria ; Neoplasm Invasiveness

To compare the diagnostic value between the thyroid imaging reporting and data system ( TIRADS) and ultrasound ( US ) patterns of 2015 American Thyroid Association ( ATA ) guidelines in the differentiation of benign and malignant thyroid nodules. 639 patients in Jiangsu province who were scheduled for ultrasound-guided fine-needle aspiration biopsy or thyroidectomy were recruited for the retrospective study. All of them were categorized based on TIRADS and ultrasound patterns of ATA ( 2015 ) guidelines. The receiver operating characteristic curve was established to assess and compare the diagnostic value of the two models. Results:( 1 ) 639 patients with 847 thyroid nodules were included in this study, 510 females and 129 males. The mean age was (46. 77 ±12.98)yearsold. (2)818nodulescouldbeclassifiedaccordingtoTIRADS. ThemalignancyratesofTIRADS2,3, 4A, 4B, 5 were 0, 15. 9%, 49. 1%, 78. 8% ,and 100%, respectively. (3) Ultrasound patterns of ATA could be assigned to 793 nodules. The malignancy rates of nodules with very low, low, intermediate, high suspicion for malignancy were 6. 2%, 10. 3%, 24. 9% and 70. 1%, respectively. (4) Ultrasound patterns of ATA had higher specificity (77. 9%) compared to TIRADS. The sensitivity and area under curve of ultrasound patterns of ATA were lower than those of TIRADS, though, not significant. Ultrasound patterns of ATA(2015) guidelines may yield higher specificity in the differential diagnosis of benign and malignant thyroid nodules, while TIRADS classification may offer a relatively higher sensitivity and area under curve.

BACKGROUNDThe sensitization and elicitation phases are involved in the immunopathogenesis of contact hypersensitivity (CHS). Langerhans cells (LCs) are believed to play pivotal roles in the sensitization stage of CHS. Local hyperthermia on skin induces the migration as well as maturation of epidermal LCs. Although fever-range whole body hyperthermia and local hyperthermia at 43°C prior to sensitization were reported to suppress CHS, the effects of different temperatures and the timing sequence of local hyperthermia on CHS have not been tackled.

METHODSLocal hyperthermia was applied to murine dorsal skin 3 days prior to, concurrent with, or 2 days post sensitization with fluorescein isothiocyanate (FITC) in BALB/c mice. Local hyperthermia temperatures at 37°C, 39°C, 41°C and 43°C were applied to mouse dorsal skin and the severity of CHS was calculated by measuring the swelling response of the challenged ears.

RESULTSLocal hyperthermia at 39°C, 41°C and 43°C prior to sensitization reduced the severity of CHS, as compared with that at 37°C. The suppression of CHS was temperature dependent in that higher temperature had a stronger effect. On the contrary, the hyperthermia treatments, either concurrent with or post-sensitization, resulted in an enhanced temperature-dependent ear swelling response.

CONCLUSIONSThe severity of murine CHS could be influenced by local hyperthermia at the sensitization stage in a temperature dependent manner. The temporal effect of local hyperthermia suggested a novel factor in interpreting the severity of allergic contact dermatitis.

Animals ; Dermatitis, Contact ; therapy ; Female ; Hyperthermia, Induced ; Langerhans Cells ; physiology ; Mice ; Mice, Inbred BALB C

OBJECTIVETo study the role of carbamyl phosphate I (CPS-I)and ornithine transcarbamoylase (OCT) levels in cirrhosis patients with and without hepatic encephalopathy, and to analyze the correlations between CPS-Iand OCT with the development of hepatic encephalopathy.

METHODSCPS-I, OCT, plasma ammonia and liver function of 95 cirrhosis patients with hepatic encephalopathy and 25 cirrhosis patients without hepatic encephalopathy in our hospital from January 2008 to December 2009 were analyzed. 60 healthy controls were recruited in the control group. The differences of serum CPS-I, OCT levels among the cirrhosis patients with and without hepatic encephalopathy and the healthy controls were analyzed; the correlations of CPS-I, OCT levels with plasma ammonia and total protein in cirrhosis patients,and the correlations of CPS-I, OCT levels with Child-Pugh classification of cirrhosis symptom severity in cirrhosis were analyzed. the clinical characteristics between patients who had HE and no HE with chi-square tests were compared. Comparisons of CPS-I, OCT levels across patients based on the Child-Pugh classification were performed with One-Way ANOVA and Student-Newman-Keuls, correlation of CPS-I, OCT with other indicators were performed with Pearson correlation analysis.

RESULTSSerum CPS-I and OCT levels in cirrhosis patients with hepatic encephalopathy were (143.3+/-48.5) U/L, (297.0+/-102.6) is multiplied by 10 U/L, which were lower than that in cirrhosis patients without hepatic encephalopathy (180.3+/-51.5) U/L, (351.8+/-109.0) is multiplied by 10 U/L (t = 2.53, t = 2.78, P < 0.01). Compared with healthy controls, serum CPS-I and OCT levels in cirrhosis patients with and without hepatic encephalopathy were all lower (t = 3.21, t = 4.16, t = 2.12, t = 3.15, P < 0.05). CPS-I was correlated with OCT, (r = 0.946, P < 0.05); CPS-I and OCT were negatively correlated with ALT and AST (r = -0.284, r = -0.239, r = -0.303, r = -0.322, P < 0.05). Additionally, CPS-I and OCT levels were negatively correlated with the Child-Pugh classification in Cirrhosis (F = 10.13, F = 20.28, P < 0.01).

CONCLUSIONThe serum CPS-I and COT levels were important factors affecting plasma ammonia in patients with cirrhosis and played an important role in the development of hepatic encephalopathy.

Adult ; Ammonia ; blood ; Carbamoyl-Phosphate Synthase (Ammonia) ; metabolism ; Case-Control Studies ; Female ; Hepatic Encephalopathy ; blood ; enzymology ; Humans ; Male ; Middle Aged ; Ornithine Carbamoyltransferase ; metabolism